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The Keys to Life and Death Decisions; Choose Wisely

The Keys to Life and Death Decisions; Choose Wisely

The Keys to Life and Death Decisions; Choose Wisely


It's your right to make decisions about your medical care, and to name someone else to make health decisions for you if you're incapacitated. That seems simple enough; you choose someone close to you and talk about which medical procedures you would want and under what circumstances you would not want them. Then you write it down and rest easy that if you become incapacitated the doctors will follow your wishes and your agent will back you up.

Only, it isn't this simple and it doesn't work this way. There is more to navigating this process than knowing which procedure to choose or not to choose. Sickness and health, life and death are complicated issues and bring a myriad of diverse and complicated human concerns, not to mention fear and crushing pain, to bear. And the people that show up at such a time can be a wild bunch; your long-estranged sister, your brother's whacky wife, or your ex-mother-in-law.

Discussing what you want with a designated agent and writing it down is important. But as important as it is to choose someone who can articulate your wishes, is choosing an agent who can alsonavigate the waves of interpersonal relationships that show up in troubled waters. Here are some suggestions for choosing an agent:

1) Choose someone who has spent enough time with you to know what you would want, not only related to health care but someone who knows how you would think or act, someone who can predict what you would order for lunch, want for a gift, and someone with whom you have discussed end of life or life sustaining issues. This might be a spouse or a child, but it also might be a neighbor or friend. This is not a love test or a competition. This is about choosing someone to "speak" for you when you no longer have a voice and it is your right to choose that voice.

2) Choose a strong voice. Believe it or not, you sometimes have to fight for appropriate care, either from a tired health care professional, an insurance company (or even family members).You don't want someone who knows what is best but who can't demand that treatment (or lack of it) on your behalf. Certainly you need to choose someone who is not easily overwhelmed and you want someone who is articulate and calm in a crisis.

3) Choose someone on good terms with most of your family and friends - this is particularly important if you are a member of a blended family. You want an agent that can discuss your care with your entire community even members who are estranged from other members, especially if your health issue is a serious or life threatening one. We all die, and we all leave people we love behind. Designating an agent who can discuss difficult decisions with all your family and friends in a way that encourages consensus or acceptance is in everyone's best interest. When consensus is not possible, designating an agent who can stand up for you in a loving and consistent manner is important.

Think about the people in your life that love you, are strong advocates, and are well respected by other people in your life. Filter, sift and talk to these people until you land on that special person who knows you, can articulate your wishes, and can communicate compassionately with all the members of your tribe that love you. Now, you have a supportable Advance Health Care Directive and the perfect designated agent.
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